In the natural orifice transluminal endoscopic surgery (hereinafter, referred to as NOTES), for example, a focus in cavity of a digestive tract or abdominal cavity is removed by a flexible endoscope inserted into the cavity of digestive tract such as a mouth, an anus or a vagina.
For example, NOTES includes surgery for removing, with a flexible endoscope, a gastric wall in which a through hole is formed, more specifically, removing a tumor lying deeper than a submucosa in the gastric wall, that is, a tumor lying in a muscularis propria.
As shown in FIG. 32, NOTES also includes surgery for removing, with a flexible endoscope S, a tumor or the like formed in a pancreas, liver or the like by inserting the flexible endoscope S from a mouth, forming a hole h in a gastric wall with a tip of the endoscope S, and causing the tip of the endoscope S to enter abdominal cavity from the hole h.
When the tumor in the gastric wall, pancreas or the like is removed by performing such NOTES, a removed region or the hole h in the gastric wall needs to be sutured after the removal. Conventionally, the flexible endoscope S enables the removal of tumor or the like, however, the removed region cannot be sutured at the cavity of the digestive tract.
Because of this, surgery in which a tumor or the like is removed with the flexible endoscope S and suturing is performed with a laparoscope is performed at present. Unfortunately, in such a case, a scar stays on a body surface because a hole for inserting the laparoscope from the body surface into the abdominal cavity needs to be formed in an abdominal wall.
If not only removal but also suturing can be performed with the endoscope S at the cavity of the digestive tract, the surgery can be performed without forming a scar on the body surface. Therefore, a technique for suturing the removed region at the cavity of digestive tract has been developed recently (for example, Patent Literature 1).
As for suturing an incised part in surgery, end faces of both edges are sutured while butting against each other in order that biological tissues easily adhere to each other. However, according to the technique disclosed in Patent Literature 1, outer faces of edges are sutured while facing each other. In other words, the outer faces of both edges in the incised part of a gastric wall are sutured in surface contact with each other. The suturing according to the technique in Patent Literature 1 therefore causes a problem that a wound is not completely closed because it is difficult to promote the adhesion of the biological tissues in the contact area.
Moreover, a part on a tip side with respect to the sutured part protrudes into the stomach in a heaped up manner at the edges of the incised part. The sutured part may cause various problems with respect to food provided to the stomach.
Further more, the part on the tip side with respect to the sutured part is not supplied with blood at the edges of the incised part. The biological tissues may necrose.
As described above, according to the technique that has been developed for suturing the removed part at the abdominal cavity, it is difficult to suture a wound similarly to a surgical operation. Therefore, development of a technique capable of suturing a wound similarly to a surgical operation has been required.